Length of Stay is a Liar - I found length of stay ("LOS") lying again. This time the subject is measuring outcomes on the sepsis bundle.

Wise men and women tell us to measure LOS and it will fall once we implement the bundles. Well, maybe not. If you buy the early goal directed story, then the severity of sepsis will be blunted and not as serious, which is a very good thing. As a sepsis survivor, I really appreciate this fact.

But let’s keep thinking. The bundles reduce mortality, right? But, death from sepsis is good for length of stay. A really sick patient is bad for length of stay. My clinical friends tell me that depending on when you catch sepsis; you could be in the hospital for a couple of weeks. So, a stay in the hospital with severe sepsis could be longer than the stay that results in death.

It could be a lot longer, in fact as much as 5 TIMES longer.
Decision makers beware! Decisions that are based on the facts from a known liar like LOS are dangerous.

Guardian and its team of data engineers and healthcare specialists, formally Amplefi, have been honored to assist a wide range of health systems, organizations and hospitals directly address their challenges using their existing dat and the expertise of their knowledge workers. These customers have included:

Let’s get right to the point. There’s a burning issue here that we need to discuss. A Clogged ED is up to 15% in lost revenue, a top reason for dissatisfaction with INSURED patients, a major source of strain and morale problems with the staff, and could be an EMTALA compliance problem. Addressing one pain point like a clogged ED, becomes a gateway to boosting safety and reliability.

Here is a quick overview—just a bit of background:

For the past 8 years we’ve been working on finding solutions to the country’s ED problem, only to find out that we were looking in the wrong direction; we now know that a clogged ED is generally a symptom of a larger process problem in the hospital. One of the biggest problems in the typical ED is that at any given time 25% to 50% of ED capacity is being utilized by admitted patients on hold for a bed in the house. So we started asking “why are these people on hold” and that exposed a set of smaller, randomly occurring problems, that were stealing bed capacity in big chunks: dirty beds, lab delays, food service, change of shift, transportation delays, family problems, late physician rounds, etc. Individually these problems all seemed minor, but as a group, they represent one of the keys to unclogging the ED. More significantly, these problems are all relatively easy to solve. When the “right” person is made aware of any of these problems, and gets engaged, they can usually solve the situation in short order.

This led to an idea -- if the “right” person could have been made aware of these problems, before they became a problem, then we would prevent the problem from occurring. If we could create this forecast, we could recapture the lost bed capacity. Furthermore, several industries with tight capacity constraints (like Automotive Manufacturing or the Airlines) have developed and used these techniques for 25 years. We wouldn’t have to invent anything just apply the concepts.

The idea will more than pay for itself. Here’s the payoff…

More Patients through the ED/shift is more money. Often, there is a potential for 10-20% improvement in volume without adding capacity. Furthermore, you get new leverage, creating a competency in these techniques will continue to serve you as you expand and grow. With each new capital expenditure, you will be able to maximize the ROI.

Here’s what we need from you to get going…

We will put a team out here for a few days to understand your situation, your goals, and quantify the opportunity.

Let's work together to unlock the value of your data and improve the safety and reliability in your hospital.